Ilyse F Zultowski, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

70015939 Issued in IL

Practice address

2533 N Southport Ave
Chicago, IL 60614-7166

Phone

(773) 472-2731

Fax

(773) 472-2761

NPI assigned

Aug 27, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ilyse F Boddy Former name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Endurance Physical Therapy PLLC

  • Sports Physical Therapist
  • Northbrook, IL
  • NPI 1679168751
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1497948053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2533 N SOUTHPORT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147166",
            "telephone_number": "773-472-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2533 N SOUTHPORT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147166",
            "telephone_number": "773-472-2731",
            "fax_number": "773-472-2761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZULTOWSKI",
        "first_name": "ILYSE",
        "middle_name": "F",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-27",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "70015939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL GROUP",
            "identifier": "1619908",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "568150",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ILYSE",
            "last_name": "BODDY",
            "middle_name": "F",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sara Zulghena, LPC
• Mikal Zuljevic, PHARMD
• David Zull, MD
• Lisa Zull, ANP-BC
• Hayley Jessica Zullow, MD, PHD
• John Paul Zulueta, MD
• Patricia Ines Mendoza Zulueta, MD
• Nicolas Zuniga Penaranda
• Andrea Zuniga
• Mariela Zuniga

• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.